Healthcare Provider Details

I. General information

NPI: 1922810969
Provider Name (Legal Business Name): CLUB MOVE PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 05/31/2025
Certification Date: 05/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23D CAMBRIDGE ST
BURLINGTON MA
01803-4601
US

IV. Provider business mailing address

43 WESTLAND AVE UNIT 507
BOSTON MA
02115-4565
US

V. Phone/Fax

Practice location:
  • Phone: 781-202-2065
  • Fax: 866-570-1753
Mailing address:
  • Phone: 781-202-2065
  • Fax: 866-570-1753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA WEBER
Title or Position: OWNER
Credential: DPT
Phone: 781-202-2065